Individual
MARGARET BASILIADIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2700 PROSPERITY AVE STE 270, FAIRFAX, VA 22031-4321
(703) 698-2431
(571) 665-6878
Mailing address
PO BOX 37174, BALTIMORE, MD 21297-3174
(571) 423-5699
(571) 423-5698
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0102206268
VA
207QG0300X
Geriatric Medicine (Family Medicine) Physician
K1776
TX
Other
Enumeration date
04/18/2006
Last updated
10/31/2021
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